Cytopenia

Cytopenia

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  CYTOPENIA DR. VERMA NISHU
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  TOPIC 1. INTRODUCTION 2. TYPES 3.APLASTIC ANEMIA  CAUSE  SYMPTOMS 4. PURE RED CELL APLASIA  CAUSE  SYMPTOMS 5. DIAGNOSIS 6. ALGORITHM FOR PANCYTOPENIA 7. TREATMENT  APLASTIC ANEMIA  PURE RED CELL APLASIA DR. VERMA NISHU 20XX 2
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  INTRODUCTION: Cytopenia occurs whenone or more of your blood cell types is lower than it should be. Your blood consists of three main parts. 1. Red blood cells, also called erythrocytes, carry oxygen and nutrients around your body. 2. White blood cells, or leukocytes, fight infection and battle unhealthy bacteria. 3. Platelets are essential for clotting. If any of these elements are below typical levels, you may have cytopenia. DR. VERMA NISHU 20XX 3
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  TYPES  Several typesof cytopenia exist. Each type is determined by what part of your blood is low or decreased. 1. Anemia occurs when your red blood cells are low. 2. Leukopenia is a low level of white blood cells. 3. Thrombocytopenia is a deficiency of platelets. 4. Pancytopenia is a deficiency of all three parts of the blood.  The possible causes of cytopenia are complex and varied. Among these causes are peripheral destruction, infections, and side effects of medication. DR. VERMA NISHU 20XX 4
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  APLASTIC ANEMIA  Aplasticanemia is not really only an anemia but it’s actually a type of pancytopenia.  Impairment or failure of bone marrow, leading to loss of stem cells and pancytopenia, the decreased number of erythrocytes, leukocytes and platelets in the blood. May be temporary or permanent DR. VERMA NISHU 20XX 5
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  CAUSE  Often idiopathicbut possible causes include 1. Myelotoxins - Radiation, industrial chemicals, drugs 2. Viruses - Particularly hepatitis C, HIV, EBV, Hepatitis, Parvovirus B19 3. Genetic abnormalities - Myelodysplastic syndrome - Fanconi anemia 4. autoimmune disease such as systemic lupus erythematosus (SLE). DR. VERMA NISHU 20XX 6
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  SYMPTOMS  Fatigue  Pallor Shortness of breath  Aplastic anemia caused by Fanconi anemia  Characteristic clinical features  Short stature  Increase incidence of tumors, leukemia  Café-au-lait spots  Thumb or radial defects  Increase risk of bleeding or bruising (Thrombocytopenia)  Increase risk of infection (Leukopenia)  Pancytopenia  Without splenomegaly  Lack of RBC precursors  Enlarged spleen  Myelofibrosis  Hairy cell leukemia DR. VERMA NISHU 20XX 7
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  PURE RED CELLAPLASIA  This is a rare form of anemia where the bone marrow ceases to produce RBC exclusively, while White blood cells and platelets are produced normally.  CAUSE: DR. VERMA NISHU 20XX 8  Congenital cause:  Diamond-blackfan anemia (abnormal ribosome synthesis)  Acquired cause:  Autoimmune disease  Tumor  Thymoma  Antibodies against EPO  Viral infection  HIV, Herpes, Parvovirus B19
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  SYMPTOMS  Fatigue  Pallor Shortness of breath  No increase risk of bleeding or bruising (Platelets normal)  No increase risk of infection (WBCs normal)  Aplastic anemia caused by Diamond-blackfan anemia  Infant with characteristic clinical features  Growth retardation  Craniofacial abnormalities  Hypertelorism and flat nasal bridge  Thumb abnormalities  Predisposition to cancer  Acute myelogenous leukemia  Myelodysplastic syndrome DR. VERMA NISHU 20XX 9
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  DIAGNOSIS DR. VERMA NISHU20XX 10
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  DR. VERMA NISHU20XX 11
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  ALGORITHM FOR PANCYTOPENIA DR.VERMA NISHU 20XX 12
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  DR. VERMA NISHU20XX 13
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  TREATMENT OF APLASTICANEMIA  RBC or platelet transfusion (supportive)  Depending on cause:  Stopping offending agent  Immunosuppressive reimens  Antithymocyte globulin  Cyclosporine (in autoimmune disease)  Treating underlying infection  Bone marrow stimulation (GM-CSF)  Only curative agent is BONE MARROW TRANSPLANT DR. VERMA NISHU 20XX 14
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  TREATMENT OF PURECELL APLASIA  RBC transfusion  Then, depending on cause:  Immunosuppressants  Thymectomy  Treating infection DR. VERMA NISHU 20XX 15
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  THANK YOU DR. VERMANISHU